Pneumococcal Vaccine Recommendations and Safety

Pneumococcal Vaccination Recommendations

For adults there are two vaccines to protect against pneumococcal disease:

Pneumococcal Polysaccharide Vaccine (PPSV23)

Pneumococcal Conjugate Vaccine (PCV13)

Both are inactivated vaccines.

Recommendations for Adults with No Previous Pneumococcal Vaccinations

The Advisory Committee on Immunization Practices (ACIP) recommends that all adults 65 years of age or older receive a dose of PCV13 followed by a dose of PPSV23 6 to 12 months later. If a dose of PPSV23 cannot be given during this time window, it should be administered later, during the next doctor’s visit. PCV13 and PPSV23 should not be administered on the same day: the minimum acceptable interval between PCV13 and PPSV23 is 8 weeks.

ACIP also recommends that adults 19 years of age or older with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants, and who have not previously received PCV13 or PPSV23, should receive a dose of PCV13 first followed by a dose of PPSV23 at least 8 weeks later.

Subsequent doses of PPSV23 should follow current PPSV23 recommendations for high risk adults. Specifically, a second PPSV23 dose is recommended 5 years after the first PPSV23 dose for persons aged 19 through 64 years with functional or anatomic asplenia and for persons with immunocompromising conditions.

A second dose of PPSV23 is not recommended for persons 19 through 64 years of age with cochlear implants or CSF leaks.

Additionally, those who received one or more doses of PPSV23 before age 65 years for any indication should receive another dose of the vaccine at age 65 years or older if at least 5 years have elapsed since their previous PPSV23 dose.

Adults 65 years of age or older who have not previously received PCV13 and who have previously received one or more doses of PPSV23 should receive a dose of PCV13. The dose of PCV13 should be given at least 1 year after receipt of the most recent PPSV23 dose.

Adults 19 years of age or older with the aforementioned conditions (functional or anatomic asplenia, immunocompromising conditions, or those with CSF leaks or cochlear implants) who have previously received one or more doses of PPSV23 should be given a dose of PCV13 one or more years after the last PPSV23 dose was received. For those who require additional doses of PPSV23, the first such dose should be given no sooner than 8 weeks after PCV13 and at least 5 years since the most recent dose of PPSV23.

The contraindications for PPSV are a severe allergic reaction (eg, anaphylaxis) after a previous vaccine dose or to a vaccine component. Individuals with moderate or severe acute illness should postpone vaccination. PPSV is one of three vaccines covered by Medicare. Medicare covers one dose per individual per lifetime, though it does cover a booster for high-risk adults if 5 years have passed since their last PPSV immunization.

Breastfeeding is not a contraindication to PPSV. The vaccine does not adversely affect the safety of breastfeeding women or their infants. Providers should make every effort to vaccinate medically high-risk women before they become pregnant. The vaccine is not contraindicated during pregnancy, but it has not been specifically studied among pregnant women.

Pneumococcal (PCV13 or PPSV23) Precautions

Pneumococcal Vaccine Safety

Pneumococcal vaccines are very safe and effective at preventing pneumococcal disease. Vaccines, like any medicine, can have side effects. The most common side effects from pneumococcal vaccines are mild and last 1 or 2 days.

Common Side Effects of Pneumococcal Vaccine

Feeling drowsy

Loss of appetite

Sore or swollen arm from the shot

Fever

Headache

Very rarely, severe (anaphylactic) allergic reactions may occur after vaccination.

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